Validación de la escala de calidad de vida MELASQoL, en un grupo de pacientes colombianas con melasma

El objetivo del estudio consistió en validar la escala de calidad de vida MELASQOL al idioma español en un grupo de mujeres colombianas con melasma. La muestra de estudio correspondió a 80 pacientes, las cuales asistieron a consulta de medicina estética de la IPS Quinta de Mutis de la Universidad del Rosario, por presentar melasma, se les pidió su participación y datos de ubicación telefónica para aplicarles la escala traducida al idioma español (MELASQOL-t) mediante la guía QoLMs (guidelines for cross-cultural adaptation of health-related), para validación de escalas propuesta por la OMS, en un segundo contacto vía telefónica. Una vez obtenida la respuesta telefónica a la escala de todas las pacientes, se procesaron los datos para validación mediante análisis estadístico; bajo los parámetros de congruencia interna, validez de criterio y reproducibilidad. Solo con una pequeña parte (n=10) de la muestra se efectuó un tercer contacto telefónico con fines estadísticos. El promedio de edad del grupo estudiado correspondió a 40±12 años, el estrato socioeconómico de mayor frecuencia fue el tres (3), con mayor distribución en el nivel educativo de estudios universitarios completos, se obtuvieron para los criterios de validación los siguientes datos: congruencia interna con a-cronbach=0.88, validez con rs=0.70-p<0.001 y reproducibilidad con coeficiente de correlación intraclase =0.959 (IC 95%: 0.986, p<0.001). La conclusión principal fue que la escala MELASQOL traducida al idioma español se validó bajo criterios adecuados, obteniendo buenos índices para medir calidad de vida en el grupo de mujeres colombianas con melasma estudiadas.

The assessment of GCSE art: Criterion-referencing and cognitive abilities

In this paper Cognitive Abilities Test scores are compared directly with moderated GCSE scores awarded to the same group of pupils. For ease of interpretation the comparisons are presented in a graphical form. Whilst some provisional and tentative conclusions are drawn about the reliability of GCSE art, questions are raised about the general validity of criterion-referenced assessment in this area.

Adverse gastrointestinal effects of arginine and related amino acids

Oral supplements of arginine and citrulline increase local nitric oxide (NO production in the small intestine and this may be harmful under certain circumstances. Gastrointestinal toxicity was therefore reviewed with respect to the intestinal physiology of arginine, citrulline, ornithine, and cystine (which shares the same transporter) and the many clinical trials of supplements of the dibasic amino acids or N-acetylcysteine (NAC. The human intestinal dibasic amino acid transport system has high affinity and low capacity. L-Arginine (but not lysine, ornithine, or D-arginine) induces water and electrolyte secretion that is mediated by NO, which acts as an absorbagogue at low levels and as a secretagogue at high levels. The action of many laxatives is NO mediated and there are reports of diarrhea following oral administration of arginine or ornithine ihine. The clinical data cover a wide span of arginine intakes f rom 3 g/d to > 100 g/d, but the standard of reporting adverse effects (e.g. nausea, vomiting, and diarrhea) was variable. Single doses of 3-6 g rarely provoked side effects and healthy athletes appeared to be more susceptible than diabetic patients to gastrointestinal symptoms at individual doses >9 g. This may relate to an effect of disease on gastrointestinal motility and pharmacokinetics. Most side effects of arginine and NAC occurred at single doses of >9 g in adults >140 mg/kg) often when part of a daily regime of similar to>30 g/d (>174 mmol/d). In the case of arginine, this compares with the laxative threshold of the nonabsorbed disaccharide alcohol, lactitol (74 g or 194 mmol). Adverse effects seemed dependent on the dosage regime and disappeared if divided doses were ingested (unlike lactitol). Large single doses of poorly absorbed amino acids seem to provoke diarrhea. More research is needed to refine dosage strategies that reduce this phenomenon. It is suggested that dipeptide forms of arginine may meet this criterion.

Health-related quality of life in Huntington's disease: a comparison of two generic instruments, SF-36 and SIP

Whereas several clinical endpoints in monitoring the response to treatment in patients with Huntington's disease (HD) have been explored, there has been a paucity of research in the quality of life in such patients. The aim of this study was to validate the use of two generic health-related quality of life instruments (the Short Form 36 health survey questionnaire [SF-36] and the Sickness Impact Profile [SIP]) and to evaluate their psychometric properties. We found that both instruments demonstrated acceptable convergent validity and reliability for patients and carers. However, there was an advantage in using the SF-36 because of its more robust construct validity and test-retest reliability; furthermore, motor symptoms appeared to influence some strictly nonmotor dimensions of the SIP. On a pragmatic level, the SF-36 is shorter and quicker to administer and, therefore, easier for patients at various stages of the disease to complete. Thus, the SF-36 would appear to be the recommended instrument of choice for patients with HD and their carers, although further work needs to be done to investigate the sensitivity of this instrument longitudinally. (C) 2004 Movement Disorder Society.

Cannabidivarin (CBDV) suppresses pentylenetetrazole (PTZ)-induced increases in epilepsy-related gene expression

To date, anticonvulsant effects of the plant cannabinoid, cannabidivarin (CBDV), have been reported in several animal models of seizure. However, these behaviourally observed anticonvulsant effects have not been confirmed at the molecular level. To examine changes to epilepsy-related gene expression following chemical convulsant treatment and their subsequent control by phytocannabinoid administration, we behaviourally evaluated effects of CBDV (400 mg/kg, p.o.) on acute, pentylenetetra- zole (PTZ: 95 mg/kg, i.p.)-induced seizures, quantified expression levels of several epilepsy-related genes (Fos, Casp 3, Ccl3, Ccl4, Npy, Arc, Penk, Camk2a, Bdnf and Egr1) by qPCR using hippocampal, neocortical and prefrontal cortical tissue samples before examining correlations between expression changes and seizure severity. PTZ treatment alone produced generalised seizures (median: 5.00) and significantly increased expression of Fos, Egr1, Arc, Ccl4 and Bdnf. Consistent with previous findings, CBDV significantly decreased PTZ-induced seizure severity (median: 3.25) and increased latency to the first sign of seizure. Furthermore, there were correlations between reductions of seizure severity and mRNA expression of Fos, Egr1, Arc, Ccl4 and Bdnf in the majority of brain regions in the CBDV+PTZ treated group. When CBDV treated animals were grouped into CBDV responders (criterion: seizure severity ≤ 3.25) and non-responders (criterion: seizure severity >3.25), PTZ-induced increases of Fos, Egr1, Arc, Ccl4 and Bdnf expression were suppressed in CBDV re- sponders. These results provide the first molecular confirmation of behaviourally observed effects of the non-psychoactive, anticonvulsant cannabinoid, CBDV, upon chemically-induced seizures and serve to underscore its suitability for clinical development.

Impact of socioeconomic and clinical factors on child oral health-related quality of life (COHRQoL)

Child oral health-related quality of life (COHRQoL) has been increasingly assessed; however, few studies appraised the influence of socioeconomic status on COHRQoL in developing countries. This study assessed the relationship of COHRQoL with socioeconomic backgrounds and clinical factors. This study followed a cross-sectional design, with a multistage random sample of 792 schoolchildren aged 12 years, representative of Santa Maria, a southern city in Brazil. Participants completed the Brazilian version of the Child Perceptions Questionnaire (CPQ(11-14)), their parents or guardians answered questions on socioeconomic status, and a dental examination provided information on the prevalence of caries, dental trauma and occlusion. The assessment of association used hierarchically adjusted Poisson regression models. Higher impacts on COHRQoL were observed for children presenting with untreated dental caries (RR 1.20; 95% CI 1.07-1.35) and maxillary overjet (RR 1.19; 95% CI 1.02-1.40). Socioeconomic factors also associated with COHRQoL; poorer scores were reported by children whose mothers have not completed primary education (RR 1.30; 95% CI 1.17-1.44) and those with lower household income (RR 1.13; 95% CI 1.02-1.26). Poor socioeconomic standings and poor dental status have a negative impact on COHRQoL; reducing health inequalities may demand dental programmes and policies targeting deprived population.

Generalized external indexes for comparing data partitions with overlapping categories

There is a family of well-known external clustering validity indexes to measure the degree of compatibility or similarity between two hard partitions of a given data set, including partitions with different numbers of categories. A unified, fully equivalent set-theoretic formulation for an important class of such indexes was derived and extended to the fuzzy domain in a previous work by the author [Campello, R.J.G.B., 2007. A fuzzy extension of the Rand index and other related indexes for clustering and classification assessment. Pattern Recognition Lett., 28, 833-841]. However, the proposed fuzzy set-theoretic formulation is not valid as a general approach for comparing two fuzzy partitions of data. Instead, it is an approach for comparing a fuzzy partition against a hard referential partition of the data into mutually disjoint categories. In this paper, generalized external indexes for comparing two data partitions with overlapping categories are introduced. These indexes can be used as general measures for comparing two partitions of the same data set into overlapping categories. An important issue that is seldom touched in the literature is also addressed in the paper, namely, how to compare two partitions of different subsamples of data. A number of pedagogical examples and three simulation experiments are presented and analyzed in details. A review of recent related work compiled from the literature is also provided. (c) 2010 Elsevier B.V. All rights reserved.

Estudo das propriedades psicométricas da escala WHOQOLold em idosos da região Nordeste

The population aging process increases the number of elderly people worldwide. In Brazil, a country of continental size, this process began in the 40s and happens with specific features in each of the different region s realities. This way, this thesis aimed to evaluate the psychometric properties of a elderly s quality of life (QOL) scale, the WHOQOL-old, in a population of the Northeast of Brazil. We sought to investigate the congruence between the content covered by the scale and the ones deemed as relevant by the participants. It aimed also study the validity evidences of the instrument s internal structure. To achieve the research objectives we adopted the design of multiple methods. The research was organized in two studies. For data collection, both studies used a sociodemographic questionnaire to obtain a profile of the participants and the Mini Mental State Exam (MMSE), used as exclusion criterion. A number of 18 elderly residents of the cities of Natal-RN and Campina Grande-PB, mean age of 73.3 years (SD = 5.9) took part od the study, They were organized into three focal groups (FG) in witch they discussed about the concept of QOL, what enhance and what hinders QOL. For Study II, a quantitative approach, 335 elderly from Campina Grande responded scale WHOQOL-old. They are between 65 and 99 years (M = 74.17, SD = 6.5). The FG data were analyzed by categorical thematic content. For the data analysis of the WHOQOL-old scale were used exploratory factor analysis and calculation of the Akaike and Bayesian information criteria. The results of both studies were triangulated. According to the discussions in the FG, health and social participation have central roles in quality of life. Social participation is related to all the other QOL s influences raised. The participants indicated the relevance of religiosity and were divided about the importance of sexual activity. Exploratory factor analysis (EFA) extracted a model of six factors. Two items (OLD_3 and OLD_9), not loaded on any factor and were excluded. The other items had factor loadings > 0.3. The response categories were reduced from five to three. After the scale changes, the empirical model showed better fit (-2loglikelihood = 8993.90, BIC and AIC = 9183.90 = 9546.24) than the theoretical model (-2loglikelihood = 18390.88, AIC = 18678.88 and BIC = 19228.11). Despite the best information criterion values, the RMESA remained above the ideal (0.06). We conclude that the WHOQOL-old presents psychometric parameters below the ideal when used with the Northeast population, but the improvements made the scale s use acceptable. The WHOQOL-old uses observable variables that matches with the participants' perceptions on quality of life. However, new strategies must be tested for a better sacale refinement

A new short and simple health-related quality of life measurement for paediatric rheumatic diseases: initial validation in juvenile idiopathic arthritis

Objective. To develop and validate a new short and simple measure of health-related quality of life (HRQL) in children with juvenile idiopathic arthritis (JIA).Methods. The Paediatric Rheumatology Quality of Life Scale (PRQL) is a 10-item questionnaire that explores HRQL in two domains: physical health (PhH) and psychosocial health (PsH). Validation of the parent proxy report and child self-report versions of the instrument was accomplished by evaluating 472 JIA patients and similar to 800 healthy children. Validation analyses included assessment of feasibility, face and content validity; construct and discriminative ability; internal structure and consistency; test-retest reliability; responsiveness to clinical change; and minimal clinically important difference.Results. The PRQL was found to be feasible and to possess both face and content validity. The PRQL score correlated in the predicted range with most of the other JIA outcome measures, thereby demonstrating good construct validity, and discriminated well between different levels of disease severity. Assessment of internal structure (factor analysis) revealed that the PhH and PsH subscales identify two unambiguously separated domains. The internal consistency (Cronbach's alpha) was 0.86. The intraclass correlation coefficient for test-retest reliability was 0.91. The PRQL revealed fair responsiveness, with a standardized response mean of 0.67 in improved patients. Overall, the PRQL appeared to be more able to capture physical HRQL than psychosocial HRQL.Conclusion. The PRQL was found to possess good measurement properties and is, therefore, a valid instrument for the assessment of HRQL in children with JIA. This tool is primarily proposed for use in standard clinical care.

Validation of the Brazilian versions of two inventories for measuring oral health-related quality of life of edentulous subjects

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

The validity of critical speed determined from track cycling for identification of the maximal lactate steady state

The objective of this study was to determine the critical speed (CS) for track cycling and to assess whether a lactate steady state occurs at this speed. Fourteen competitive cyclists performed the following tests on an official cycling track (333.3 m): 1) incremental test for determination of the intensity corresponding to 4 mM of blood lactate (onset of blood lactate accumulation, OBLA) and maximal oxygen uptake (VO(2)max); 2) CS: 3 maximal bouts for distances of 2, 4 and 6 km executed in random order and with a period of recovery of 40 to 50 min between bouts. CS was determined for each subject from the linear regression between the distance and the time taking to cycle it; 3) Endurance test in which subjects were instructed to pedal at 100% of their individually determined CS for 30 min. At the 10(th) and 30(th) min (or upon exhaustion), 25 mul of blood were collected from ear lobe for later analysis of blood lactate [Lac]b. An increase less than or equal to1 mM between 10 and 30 min of exercise was considered as the criterion for the occurrence of the lactate steady state. CS (49.6 +/- 8.6 ml.kg(-1).min(-1); 36.9 +/- 2.7 km.h(-1)) was significantly higher than OBLA (43.7 8.0 ml.kg(-1).min(-1); 35.24 +/- 2.6 km.h(-1)) although the two parameters were highly correlated (r=0.97). During the endurance test, only 8 of the 14 subjects completed the 30 min period at CS. of these 8 subjects, only 2 presented a lactate steady state. Time to exhaustion at CS was 20.3 +/- 1.6 min for the remaining 6 subjects. The 12 subjects who did not reach a lactate steady state presented mean [Lac]b values of 7.4 +/- 1.3 mM at 10 min and of 9.4 +/- 1.9 mM at the end of the test (exhaustion), characterizing an exercise intensity of high lactacidemia. on the basis of the present results, we can conclude that CS determined by a track cycling test seems to overestimate the intensity of the maximal lactate steady state for most subjects.

Validity and reproducibility of a laser fluorescence system for detecting the activity of white-spot lesions on free smooth surfaces in vivo

The aim of the study was to determine the reproducibility and validity of DIAGNOdent in detecting active and arrested caries lesions on free smooth surfaces. Volunteers were selected from state schools of Piracicaba, São Paulo, Brazil. Overall, 220 lesions were clinically examined. Two specially trained ('calibrated') examiners performed both clinical and laser evaluations independently, and after a 1-week interval, the examinations were repeated, the intra-examiner agreement for the laser evaluation was substantial (kappa(ex1) = 0.79, kappa(ex2) = 0.71). There was almost perfect agreement between the two examiners for the clinical examination (kappa(ex1) = 0.95, kappa(ex2) = 0.85). The inter-examiner agreement showed substantial reproducibility (kappa = 0.77) for the laser examination and almost perfect agreement (kappa = 0.85) for the clinical evaluation. The validation criterion was the clinical examination of white spots, recorded as active or arrested. The sensitivity was 0.72 and the specificity was 0.73, which indicates that the DIAGNOdent was a good auxiliary method for detecting incipient caries lesions on free smooth surfaces. The utilization of both methods can improve the efficacy of caries diagnosis. Copyright (C) 2002 S. Karger AG, Basel.

Reproducibility and validity of self-perceived oral health conditions

The reproducibility and validity of self-perceived periodontal, dental, and temporomandibular joint (TMJ) conditions were investigated. A questionnaire was applied in interview to 200 adults aged from 35 to 44, who were attending as casual patients at Araraquara School of Dentistry, Sauo Paulo State University, Sauo Paulo, Brazil. Clinical examination was based on the guidelines of the World Health Organization manual. The interview and the clinical examination were performed in two occasions, by a calibrated examiner. Reproducibility and validity were, respectively, verified by kappa statistics (kappa) and sensitivity (Sen) and specificity (Spec) values, having clinical examination as the validation criterion. The results showed an almost perfect agreement for self-perceived TMJ (kappa=0.85) and periodontal conditions (kappa=0.81), and it was substantial for dental condition (kappa=0.69). Reproducibility according to clinical examination showed good results (kappa=0.73 for CPI index, kappa=0.96 for dental caries, and kappa=0.74 for TMJ conditions). Sensitivity and specificity values were higher for self-perceived dental (Sen=0.84, Spec=1.0) and TMJ conditions (Sen=1.0, Spec=0.8). With regard to periodontal condition, specificity was low (0.43), although sensitivity was very high (1.0). Self-perceived oral health was reliable for the examined conditions. Validity was good to detect dental conditions and TMJ disorders, and it was more sensitive than specific to detect the presence of periodontal disease.

Reliability and validity of self-reported burnout in college students: A cross randomized comparison of paper-and-pencil vs. online administration

Internet data collection is becoming increasingly popular in all research fields dealing with human perceptions, behaviors and opinions. Advantages of internet data collection, when compared to the traditional paper-and-pencil format, include reduced costs, automatic database creation, and the absence of researcher-related bias effects, such as availability and complete anonymity. However, the validity and reliability of internet gathered data must be established, in comparison to the usual paper-and-pencil accepted formats, before an inferential analysis can be done. In this study, we compared questionnaire data gathered from the internet with that from the traditional paper-and-pencil in a sample of college students. The questionnaires used were the Maslach Burnout Inventory - Student Survey (MBI-SS), the Oldenburg Burnout Inventory (OBI-SS) and the Copenhagen Burnout Inventory (CBI-SS). Data was gathered through a within-subject cross randomized and counterbalanced design, on both internet and paper-and-pencil formats. The results showed no interference in the application order, and a good reliability for both formats. However, concordance between answers was generally higher in the paper-and-pencil format than on the internet. The factorial structure was invariant in the three burnout inventories. Data gathered in this study supports the Internet as a convenient, user-friendly, comfortable and secure data gathering method which does not affect the accepted factorial structures existent in the paper format of the three burnout inventories used. (C) 2011 Elsevier Ltd. All rights reserved.

Influence of exercise mode and maximal lactate-steady-state concentration on the validity of OBLA to predict maximal lactate-steady-state in active individuals

The aim of this study was to analyze the effects of exercise mode on the validity of onset of blood lactate accumulation (OBLA-3.5-mM fixed blood lactate concentration) to predict the work-rate at maximal lactate steady state (MLSSwork-rate). Eleven recreationally active mates (21.3 +/- 2.9 years, 72.8 +/- 6.7 kg, 1.78 +/- 0.1 m) performed randomly incremental tests to determine OBLA (stage duration of 3 min), and 2 to 4 constants work-rate exercise tests to directly determine maximal lactate steady state parameters on a cycle-ergometer and treadmill. For both exercise modes, the OBLA was significantly correlated to MLSSwork-rate, (cycling: r = 0.81 p = 0.002; running: r = 0.94, p < 0.001). OBLA (156.2 +/- 41.3 W) was lower than MLSSwork-rate (179.6 +/- 26.4 W) during cycling exercise (p = 0.007). However, for running exercise, there was no difference between OBLA (3.2 +/- 0.6 m s(-1)) and MLSSwork-rate (3.1 +/- 0.4 m s(-1)). The difference between OBLA and MLSSworkrate on the cycle-ergometer (r = 0.86; p < 0.001) and treadmill (r = 0.64; p = 0.048) was significantly related to the specific MLSS. We can conclude that the validity of OBLA on predicting MLSSwork-rate is dependent on exercise mode and that its disagreement is related to individual variations in MLSS. (C) 2007 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.